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, - Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00019907 Site Location: 4104 SECTION AVE Account ID: AR0019048 <br /> Receivedby.• EE0009157 BARCELL!QS Received Date: 10/29/2003 PrintDate:i0130/2003 11:05:41AM <br /> Assigned To: EE0001699 YOAKUM Assigned Date: 10/29/2003 <br /> Program/Element Code:1600-FOOD PROGRAM <br /> — Complainant: : <br /> <br /> !Nature of complaint., <br /> SHIGELLA CONFIRMED AND POSSIBLE FROM QUESO FRESCO PURCHASED @ FACILITY <br /> Complaint Made: A Complaint Mode Codes A-Agency Referral B-Bd of Supervisors I City Council C-Counter k <br /> E-Code Enforcement M-Mail l Correspondence O-Other EH Unit P-Phone a <br /> ---------- --------------------------------------- <br /> FACILITY <br /> ------- ------ --- <br /> FACILITY INFORMATION OWNER INFORMATION <br /> Facility:FA0012013-LA TAPATIA MEAT MARKET Owner: OW0009312-ZEPEDA,RAUL <br /> i <br /> Site Location 4104 SECTION AVE RP/DBA : <br /> STOCKTON,CA 95215 RP Address 2339 W HAMMER STE C LN <br /> STOCKTON,CA 95209 <br /> Mailing Address: 4104 SECTION AVE Billing Address 5676 NATOMA CIR <br /> STOCKTON,CA 95215 STOCKTON,CA 95219 <br /> Nome Phone :209-476-8158 <br /> Phone :209-466-7716 Work Phone <br /> District Location Code 01 -STOCKTON <br /> APN 17318101 <br /> Date Abated //-I{,.G 3 Inspector J 20'qrK141 <br /> Send Referral to Referral Letter Sent by <br /> Referral Address Date: <br /> '^ f <br /> Complaint Status Code:V <br /> Circle appropriate Status Code <br /> 01-FIELD ABATED 14-ENFORCEMENT CASE-Transferred to ER FILE <br /> 02-OFFICE ABATED 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# <br /> 03-NAI SENT 16-LETTER SENT TO TENANT <br /> 04-NOTICE TO ABATE ISSUED 17-15 DAY LETTER SENT <br /> 05-ENFORCEMENT ACTION INITIATED 18-ENFORCEMENT CASE-Transferred to VECTOR CONTROL FILE <br /> 06-EHD PERMIT FACILITY-see Linked PROGRAM FACILITY FILE 19-ENFORCEMENT CASE-Transferred to WELL PROGRAM FILE <br /> 07-REFERRED TO OTHER AGENCY 0-FOODBORNE ILLNESS-Unconfirmed <br /> 08-UNABLE TO VERIFY 29-FOODBORNE ILLNESS-Confirmed <br /> 09-FOODBORNE ILLNESS 50-LEAD HAZ EVALUATION REQUIRED(1) <br /> 10-SUBSTANDARD PROPERTY-SEE HOUSING ABATEMENT FILE 51 -LEAD HAZ WORK PLAN SUBMITTED(2) <br /> 11-Multiple Complaints-SEE ACTIVE CASE# 52-LEAD HAZ ABATEMENT IN PROGRESS(3) <br /> 12-ENFORCEMENT CASE-Transferred to LIQUID WASTE FILE 53-LEAD HAZ VISUAL INSPECT SATISFACTORY(4) <br /> 13-ENFORCEMENT CASE-Transferred to SOLID WASTE FILE 54-LEAD HAZ DUST EVALUATION SATISFACTORY(5) <br /> 5104.rpt <br />